SNAP Childcare

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SNAP Childcare Registration Form

To help us find you the right job:

1. Complete the form as fully as possible, then press submit button (just once!)
2. Send in your current CV, ideally by e-mail (Word document)
3. Keep in touch with us by phone or e-mail so we know you are still seeking work
4. Call us to arrange a time to come in and see us/arrange a telephone interview
5. Keep checking on our website and let us know if you see jobs that are of interest to you.

Any information provided will be used in the strictest confidence and only for the purpose of finding you a suitable job.
SNAP is registered with and complies to the Data Protection Act 1998.
Your details will never be passed onto a third party, except with your explicit permission

Name:

Title

First Name

Surname

Maiden Name:

/Not Applicable

Date of Birth:

Date

Age:

Address:

Address 1	Address 2

Town/City (E.g. Brighton/Highbury)

County
London

Other, Please state

Postcode

Country (if not UK)

Other, Please state

Nearest tube/train station

Telephone / Email:

Daytime

Evening

Mobile:

E-mail:

* you must complete this - we won't automatically
receive your e-mail.

Name, address and telephone number of next of kin.
(We will only contact this person in case of emergencies)

Name and
Address:

Tel:

Marital Status:

Single	Married	Widow/er
Divorced	Living With Partner	In a Civil Partnership, Marriage

Nationality:

British

Other

Do you have
a current passport?:

Yes

If not a UK Citizen, do you have permission to work here? Yes No
If No, I'm sorry we can't help you! Do not send any details until you have a valid work permit.

If yes, what type of visa do you have:

Two year working Visa	Ancestral Visa	Au Pair Visa
Four year working visa	EU Citizen	Student Visa
Right to Abode	Married to UK Citizen	UK Residency

Other, please state:

When is your visa valid until?

For non UK citizens, please note - you must be in the UK to be able to attend interviews and
you must have a valid work permit - we cannot help you obtain one.

Do you have
siblings?:

Yes

if yes how old are they now?

What are your
hobbies?

Why do you wish
to work with
children with
additional needs?:

Do you have any
holidays booked?:

Yes

If yes, please state dates

Have you had
an ENHANCED CRB
police check within
the last 3 years?:

Yes

If no, have you
started the process?:

Yes

If no: please contact us directly, or see the section regarding police checks in Nannies/Carers or Articles of
interest (- after you have submitted the form, otherwise you may lose information on the form!).

Have you ever had
a criminal Record? :

Yes

If yes, please give details on a separate sheet

Religion (if practising):

Are you a driver?:

Yes

Automatic Only

Do you have
any points on
your licence?
(i.e. for speeding etc)

Yes

If yes, please state details

Do you own a car?:

Yes

Have you driven
in London
(or other large city)? :

Yes

Do you smoke?:

Yes

Socially

Do you swim?:

Yes

Not very well!

Do you have children
of your own? :

Yes

If yes, please give ages

When are you
available
to start work?:

Notice to be given in current job

POSITION DETAILS

First Choice :

Permanent Daily	Permanent Live-in	Permanent Daily or Live-in
Temporary Daily	Temporary Live-in	Temporary Daily or Live-in
Part-time Daily	Part-time Live-in	Part-time Daily or Live-in

Second Choice :

Permanent Daily	Permanent Live-in	Permanent Daily or Live-in
Temporary Daily	Temporary Live-in	Temporary Daily or Live-in
Part-time Daily	Part-time Live-in	Part-time Daily or Live-in

If temporary, dates available	If part time, days & times available

Areas Considered:

(e.g. London, Brighton, Any)

What is the youngest
age group you have
worked with?:


	And the eldest:

In total, how many years (or months) childcare experience
(Either special needs or mainstream) do you have?

Year

Months

Current/previous
weekly wage :

Net(after tax & NI)

Gross (before tax & NI)

Please state any relevant qualifications
(Btec National Diploma, Degree Childcare & Education, BSL etc) you have:

MEDICAL DETAILS

How many times have you seen a doctor in the last 12 months?

Approximately how many days sick have you taken in the last 12 months?

Do you have any
medical/psychiatric
condition(s) that may
affect you doing
your job?

Yes

if yes please give details

Are you current taking any medication/ Receiving medical/ psychiatric treatment?

Yes

if yes please give details

Have you ever suffered form any of the following: Depression, suicidal tendencies,
eating disorders, self-harming, drug dependency, death of own child or miscarriage?

If yes, please put in details below or speak to us confidentially.

Yes

If yes, we may need to discuss these privately with you, but this
won't automatically affect you getting work through us.

Please state your
approximate height
and weight:

Height:

Weight:

Have you had any
serious illnesses /
operations that may
affect your work?

Yes

If yes, please give details

Are you allergic
to anything:

Yes

If yes, please give details

* Must be completed by all applicants Medical Declaration:

I declare that I am physically and mentally fit to work with children/young adults with additional needs:

Name:

Dated:

Are you
a vegetarian?:

Yes

If yes, would you be prepared to cook meat?

Yes

Any other
languages spoken:

References. Please write down the names and details of at least two people who have known you in a professional capacity, who will provide a reference for you. One must be your most recent employer and one a childcare position where you have been for at least 3 months. (Newly qualified childcare students, may give their tutor as one reference). Please make sure you provide a current telephone number and full postal address-. Remember, if we can’t contact these people, we can’t find you a job!

Please note: If you don't want references contacted - don't put down their details - if we arrange an interview with us, we write to all references you put down.

Do not write - see CV - we need the information filled in below!

Name

E-mail

Address

Relationship (e.g. employer / tutor)
	Tel:

Name

E-mail

Address

Relationship (e.g. employer / tutor)
	Tel:

Name

E-mail

Address

Relationship (e.g. employer / tutor)
	Tel:

What are you currently doing?

Does your current employer know you are leaving?

Yes

Where did you hear about SNAP! Childcare?

The Lady	Nursery World	nannyjob.co.uk
Internet Search	Referral/Word of mouth
Guardian	Gumtree	Other, please state

Why are you leaving / did you leave, your current / previous job?

Please use this space to tell us your ideal job through SNAP - the more you tell us the
more likely we can find you the right job!

If you are interested in a specific job(s), please quote the Ref (V) Numbers(s).

All of our positions are with babies, children or young adults with additional needs, please briefly describe what experience you have experience of any of the following. We will use this information to create a topsheet which we send to potential employers, so please be specific - you can type up to 250 characters.

If you do not have any experience, please just leave boxes blank.


Portage
British Sign language
Makaton Sign Language
Physiotherapy
Speech Therapy
Occupational Therapy
Lovaas / ABA
Conductive Education
Down's syndrome
Challenging Behaviour
Autism
Cerebral Palsy
Visual Impairment
Hearing Impairment
PECS
Learning Difficulties
Lifting (Hoist etc.)
Tube Feeding
Tracheostomies
Premature Births
Epilepsy
Nannying
Mainstream childcare
Other - please state

Have you already
sent your CV?:

Yes

Not yet

I don't have one

(We will send you a blank one to complete)

DECLARATION

Having read the information I have provided, I declare that to the best of my knowledge this information is true and accurate. I understand that to register with SNAP! Childcare I will agree to undergo a police check if I do not already have a current CRB. I agree for staff at SNAP! Childcare to contact the referees I have put down on this form.

Name Printed

Date

Month

Year

Please answer the following question to prove that you are a real person

What is the sum of two plus two?

Click once to send details (please be patient - it make take about 30 seconds, but once is enough...)

Dear SNAP,
Thank you so much for your
help. Sarah & Oscar are doing
well - fabulous service.

- N. J. London

*(Excluding USA/Scotland due to specific visa / legislation restrictions)